THE DEATH toll among Irish men and women in the war wasn't confined to soldiers serving on the front line. Some 230 doctors were among the casualties, with many buried abroad where they perished.

The initial numbers volunteering for service were low, which prompted the Director General of Britain's Royal Army Medical Corps (RAMC) to write in 1914 to the Royal College of Physicians of Ireland requesting that they recommend young doctors to volunteer for service.

The response was disappointing, with the college saying they were "unable to furnish any names of candidates at the present time".

Historian David Durnin from UCD says this was indicative of the initial response of the Irish medical profession to the war.

To encourage more doctors to join up, an Irish Medical War Committee was established in 1915.

In all, some 3,000 doctors, including 400 students, enlisted. Men and women also served as medical officers, nurses, and worked in field ambulance divisions and casualty clearing stations.

Irish medics had a long, established history of serving in the RAMC. Dr Joe Duignan, who has researched the role that Irish doctors played in the war, said about one-third of the doctors in the British Armed Forces at the beginning of the war were Irish, from a combined total of 800.

By 1918, some 3,000 of the 12,500 were from the 32 counties – 230 of whom never came home.

The reason that so many were killed was because they served in regimental aid posts, which were located close to the front.

Although most were armed, they rarely fired a shot and they often went with captured troops across the German lines, continuing to operate on their comrades and the enemy.

The Irish Medical War Committee appealed for volunteers through letters and newspaper advertisements.

The first Irish medics travelled to France in August 1914, just weeks after war was declared.

The No.1 Stationary Hospital, No.1 General Hospital and No.13, 14, and 15 Field Ambulance Divisions departed Dublin for Le Havre on August 18. The same day, No. 16 and 17 Field Ambulances departed Cork for Saint-Nazaire.

Life at the front was difficult. Stretcher-bearers collected injured soldiers from the combat zone and carried them to the nearest Regimental Aid Post, often located in shell craters or the ruins of buildings.

The wounded would then be transported to Advanced Dressing Stations where their wounds were dressed, before being moved via field ambulances – either horse-drawn carriages or motor vehicles – to a Casualty Clearing Station.

Here, surgery was performed before the men were moved to nearby hospitals.

Medical officers also identified men who were more suited to treatment at home, and they were moved via hospital ship.

Each ship, most of which landed in Dublin, carried an average of 400 soldiers. In all, around 16,000 sick and wounded returned home, and were treated both in existing hospitals or auxiliary hospitals established to cope with the influx.

Some 70 institutions located throughout the country provided facilities, including specialist units.

They included the Duke of Connaught hospital in Bray, where artificial limbs were fitted; the Richmond War Hospital in Dublin, where men suffering from shell shock were treated; the King George V Hospital in Dublin, which was used as a specialist neurological unit; the Portobello Military Hospital, Temple Hill in Blackrock, where orthopaedic treatment was offered; and the Central Military Hospital at Victoria Barracks, Cork.

The Richmond War Hospital, located in Dublin's Grangegorman Asylum, catered for soldiers suffering from mental disorders. Between 1915 and 1919, when it closed, it treated 362 men, most of whom were discharged to friends or ordinary military hospitals. Two returned to duty and 31 were sent directly to civil asylums.

Another, the Belfast Lunatic Asylum, treated some 1,193 men with mental illness between 1917 and 1919, Durnin notes.

Everything was done for the wounded soldiers to ensure their comfort during convalescence.

Kildare County Council's Collection and Research Services noted that wounded soldiers of the Royal Dublin Fusiliers at Naas and the Curragh military hospitals received presents of chocolates from Cadburys, and cakes and other food from local women for Christmas of 1915.

Entertainment was also laid on: "On Thursday in the Town Hall, Naas, a very pleasing entertainment was given to the wounded soldiers who are at present in the Naas Depot Military Hospital," the 'Leinster Leader' of September 4, 1915, noted.

"The entertainment was in the hands of a local committee of lady organisers and the presence of the band of the Royal Dublin Fusiliers added much to the enjoyment of the occasion. The hall was crowded with military and the surrounding gentry were in force. The entertainment (broke) the monotony of hospital life for those wounded Irish soldiers."

Among the staff in the auxiliary hospitals were voluntary aid groups or detachments (VADs), comprising men and women who passed a first aid course and received instruction in hygiene.

As the war continued and the casualties grew, the demand for hospitals increased. Writing in 'History Ireland', chairman of the Royal Dublin Fusiliers Association, Tom Burke MBE, said money was raised through voluntary contributions to equip and manage the hospitals, with volunteers working as ambulance personnel and nurses' aids.

Much of the work was difficult, with one volunteer writing that "long hours, much scrubbing and carrying of meals, being at the beck and call of an uncertain-tempered staff nurse and other menial work, with plentiful blame for what they had not done, combined to make their sacrifice a very real one".